DA FORM 4029 Fillable – Army Pubs 4029 PDF

DAFORMFILLABLE.COM | DA FORM 4029 Fillable – Army Pubs 4029 PDF – The DA FORM 4029, commonly referred to as the Patient’s Clearance Record, is an essential document used within the United States Army Medical Department. This form plays a crucial role in managing the administrative aspects of a patient’s healthcare journey, particularly when transitioning from one healthcare facility to another. In this article, we will delve into the details of DA FORM 4029, its purpose, and how it is used within the military health system.

DA FORM 4029 – Patient`S Clearance Record

Form Number DA Form 4029
Form Title Patient`S Clearance Record
Form Date 03/01/1973
Form Proponent TSG

What is DA FORM 4029?

DA FORM 4029 is designated as the Patient’s Clearance Record. It was first introduced on March 1, 1973, and remains an active part of the Army’s medical documentation system. This form is unclassified and is approved for public release, meaning it can be distributed without restriction.

Key Details of the Form

  • Pub/Form Number: DA FORM 4029
  • Pub/Form Date: 03/01/1973
  • Title: Patient’s Clearance Record
  • Proponent: The Surgeon General (TSG)
  • Status: Active
  • Prescribing Directive: AR 40-400
  • Security Classification: UNCLASSIFIED
  • Distribution Restriction: Approved for public release; distribution is unlimited

Purpose of DA FORM 4029

The primary purpose of the DA FORM 4029 is to ensure that all necessary medical and administrative procedures have been completed before a patient is cleared from a medical facility. This form facilitates a smooth and organized transition by recording details about the patient’s current health status and any required follow-up care or instructions.

How It Is Used

  1. Medical Clearance: The form is used to document that a patient has been medically cleared by their healthcare provider. This includes finalizing any treatments and ensuring that the patient is stable enough to be discharged or transferred.
  2. Administrative Record: It serves as an administrative record, helping healthcare staff track the completion of various procedures and the patient’s readiness for discharge.
  3. Coordination of Care: By documenting detailed information about the patient’s treatment and recovery plan, DA FORM 4029 assists in coordinating care with other healthcare providers or facilities.

Completing DA FORM 4029

When completing the Patient’s Clearance Record, it is important to be thorough and precise. The form should include:

  • Patient Identification: Full name, rank, and service number of the patient.
  • Medical Information: Details about the patient’s diagnosis, treatment received, medications prescribed, and any special instructions for continued care.
  • Clearance Signatures: Signatures from the various departments that have treated the patient, confirming that all necessary actions have been taken.

Sections to Be Filled

  • Patient Details: Basic information about the patient.
  • Treatment Summary: A summary of the treatment and any ongoing care instructions.
  • Department Clearances: Sign-offs from relevant departments within the medical facility.

Importance of DA FORM 4029 in Patient Care

The DA FORM 4029 is more than just a piece of paper; it is a critical tool in the continuum of care. By ensuring that all medical and administrative tasks are completed, this form helps prevent any gaps in the care provided to service members. It supports the efficient transfer of information and ensures that patients receive consistent and coordinated care across different healthcare settings.

Benefits for Healthcare Providers and Patients

  • For Healthcare Providers: Ensures that all necessary medical information is communicated clearly and efficiently.
  • For Patients: Provides a documented plan for follow-up care and ensures that no critical information is overlooked during transitions between facilities.


The DA FORM 4029 – Patient’s Clearance Record is an indispensable tool in managing the health and well-being of service members. By meticulously documenting the necessary medical and administrative steps, this form plays a pivotal role in enhancing patient care and facilitating effective communication among healthcare providers. As such, understanding and correctly utilizing DA FORM 4029 is vital for anyone involved in the medical care of military personnel.

DA FORM 4029 Fillable – Army Pubs 4029 PDF DOWNLOAD

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